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How Ketoconazole Shampoo Can Help With Hair Restoration

Posted Apr 25 2014 1:32am

Hair loss forums sometimes include posts made by patients on using ketoconazole shampoo.  Naturally, those who are suffering from pattern baldness might be curious in knowing what this is and how it works as a hair restoration treatment.


2% Ketoconazole is available on a prescription basis.  It is typically used for fungal related skin diseases. One example of a brand name drug is Nizoral shampoo (2% ketoconazole) which may be recommended for use alongside Minoxidil (Rogaine) or Finasteride (Propecia). Therefore, ketoconazole is not used by itself as a treatment for hair restoration. Instead, it is meant to enhance the effects of both FDA approved drugs.

Recently a 1% version of ketoconazole shampoo has been made available over the counter.

Why Would An Anti-Fungal Agent Help With Hair Restoration?

Ketoconazole works by interfering with the lifecycle of fungal micro-organisms. However, it is relevant to the area of hair restoration due to its other properties.

(1) ability to occupy androgen receptors on the hair follicle

(2) ability to fight inflammation

(3) ability to decrease sebum levels

Normally, DHT molecules bind to protein receptor sites located at the base of the hair follicle. In those who have the genetics for pattern baldness, there is less protection against the detrimental effects of dehydrotestosterone due to the way the receptors are structured.

However, the configuration of ketoconazole molecules allows them to occupy these sites. And this  helps prevent vulnerable follicles from miniaturizing due to the presence of DHT.

The hair follicles become targets of attack by the immune system as they start to deteriorate from the action of dehydrotestosterone. These processes can impair the normal production of hair. So ketoconzaole’s anti-inflammatory processes can help reverse these effects.

Decreasing sebum helps to keep the hair follicle pores unobstructed. This in turn provides a much better environment for the formation of new hairs.

Research on Ketoconazole’s Hair Restoration Effects

Studies were designed to observe the effectiveness of:

(1) Finasteride alone

(2) Minoxidil alone

(3) Finasteride and Ketoconazole

(4) Finasteride and Minoxidil

The use of finasteride and minoxidil rendered the best results. Second to this was the combination of finasteride and ketoconazole. This study was published in 2002 by the Journal of Dermatology.

Another study was conducted in Japan. Shaved mice were either given ketoconazole shampoo or a placebo. Hair growth was observed for both groups.  The mice who received the ketoconazole shampoo experienced better growth compared to the control.

Who Can Use Ketoconazole Shampoo For Hair Restoration?

Ketoconazole can be used for male and female pattern baldness.

Whether or not an individual qualifies to receive a prescription for Ketoconazole shampoo would need to be determined by a doctor. But in general, the drug is contraindicated for patients who are allergic to its ingredients.

Based on an understanding of how ketoconazole works to  enhance hair restoration treatments, it is clear that it offers the most promise for the earliest stages of androgenic alopecia. This is when the hair follicles have just started to become affected by DHT.


The drug is less likely to be effective for more advanced stages of pattern baldness.







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